Interesting research but is it all balls?

A survey suggesting that British men check their testicles for cancer more often than men elsewhere in Europe could have health campaigners patting themselves on the back but what does it really mean?

Apparently, the number of young British men who check their testicles for signs of cancer has tripled in a decade and testicle-awareness among British and Irish men is now double the European average.

In 1990, 10% of British men checked their testicles but a new report by Cancer Research UK shows that this was up to 36% by 2000. (The European average was 18%.)

MNHF CEO Peter Baker said: 'This study shows that campaigns to increase men's awareness of health can make a real difference to their behaviour. What we need to do know is to apply the lessons learned from testicular cancer — which is relatively rare — to tackle the much more common cancers as well as other major diseases like heart disease and diabetes. We also need to change the way health services are delivered so that men find them easier to use.

'There is also a danger with highly effective campaigns on any medical condition that it might skew mens perception of risk. Most men for instance, place a higher fatality risk from testicular cancer than from suicide despite overwhelming evidence to the contrary.'

All good points but can we be sure that the survey is relaible anyway? It was based on asking students about self-examination. The study quizzed 17,000 university students in European countries in 1990 and almost 19,000 students ten years later in 2000. The researchers themselves admit that asking students may overstate the levels in the wider population because, say the researchers, they are better educated and tend to have higher levels of health awareness. But the bigger question is: are these students telling the truth?

Do they really examine themselves or have they just got the idea based on the success of men's health campaigns that they should be? Students are, after all, very good at giving what they think the people asking the questions view as the right answer. That's why they've made it to university.

Professor Michael Baum, who has argued that the problems caused by breast cancer screening in terms of increased patient worry and the carrying-out of procedures which are later shown to be unecesssary more than outweigh the benefits in lives saved, has a similar scepticism about testicular examination. He says: 'For all we know British men may also have the highest level of false alarms and unnecessary orchidectomy (removal of the testis) without any impact on death from testicular cancer in Europe. We need a comparitive trial of testicular self-examination versu non-testicular examination. Maybe that's what the MHF should be campaigning for.'

With the exception of Germany, the proportion of men examining their testicles had gone up in all 13 European countries studied. In Germany the rate had fallen from 24.6% - the highest in 1990 — to 16.7%.

Iceland remains the least enthusiastic country for testicular self-examniantion. Any jokes along the lines of the explanation for this being that the country is cold enough to freeze the balls off a brass monkey are not needed.

The TSE Top Ten

1. England 36% (10.4%)
2. Ireland 34% (19.9%)
3. Hungary 24% (18.8%)
4. Portugal 23.7% (18.7%)
5. Spain 20.6% (13.5%)
6. Italy 17.9% (17.8%)
7. Germany 16.7% (23.6%)
8. Poland 16.7% (5.9%)
9. Belgium 13.6% (7.8%)
10. Greece 12.6% (9.2%)

11. France 12.3% (10.1%)
12. Netherlands 9.6% (6.8%)
13. Iceland 6.5% (2.3%)